Individual provider · Type 1 NPI

Lane Gustafson

Pediatric Nurse Practitioner · Seattle, WA

NPI number 1831870260 Active

Practice location

4800 Sand Point Way NE
Seattle, WA 98105-3901

Call (509) 703-2183 Map

Mailing address

643 W Nickerson St
Seattle, WA 98119-1574

Specialties and licenses

Taxonomy	Code	License
Pediatric Nurse Practitioner Primary	363LP0200X	ARNP.AP.70118653-NP (WA)
Pediatric Registered Nurse	163WP0200X	RN1355886 (WA)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1831870260

Lane Gustafson's National Provider Identifier is 1831870260, issued on Jul 27, 2023. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Seattle, WA. The record was last updated on Oct 21, 2026.